PMID- 24961714
OWN - NLM
STAT- MEDLINE
DCOM- 20160615
LR  - 20211021
IS  - 2044-6055 (Print)
IS  - 2044-6055 (Electronic)
IS  - 2044-6055 (Linking)
VI  - 4
IP  - 6
DP  - 2014 Jun 24
TI  - The safety and efficacy of daptomycin versus other antibiotics for skin and 
      soft-tissue infections: a meta-analysis of randomised controlled trials.
PG  - e004744
LID - 10.1136/bmjopen-2013-004744 [doi]
LID - e004744
AB  - OBJECTIVE: Daptomycin, a cyclic lipopeptide that exhibits rapid, 
      concentration-dependent bactericidal activity in vitro against a broad spectrum 
      of Gram-positive pathogens, has now, since 2003, been approved in more than 70 
      countries and regions to treat skin and soft-tissue infections (SSTIs). The 
      purpose of this meta-analysis was to compare the safety and efficacy of 
      daptomycin with other antibiotics, especially with vancomycin which has long been 
      considered the standard therapy for complicated SSTIs. DESIGN: Meta-analysis of 
      randomised controlled trials (RCTs). DATA SOURCES: We thoroughly searched PubMed, 
      EMBASE, Cochrane Central to identify relevant RCTs. Six RCTs with a total of 1710 
      patients were included in this meta-analysis. RESULTS: The results demonstrated 
      that the efficacy of daptomycin was at par with or maybe better than other 
      first-line antibiotics for treating SSTIs as shown by the OR for clinical success 
      (OR=1.05, 95% CI 0.84 to 1.31, p=0.65, I(2)=0%); daptomycin versus vancomycin 
      subgroup (OR=1.19, 95% CI 0.77 to 1.83, p=0.43, I(2)=0%); overall microbiological 
      success (OR=1.05, 95% CI 0.61 to 1.79, p=0.86, I(2)=42%); microbiological success 
      of daptomycin versus comparators for Staphylococcus aureus (SA, OR=1.05, 95% CI 
      0.61 to 2.60, p=0.53, I(2)=47%), for methicillin-resistant S. aureus (OR=0.90, 
      95% CI 0.77 to 1.06, p=0.20, I(2)=56%). However, daptomycin tended to have a 
      similar treatment-related adverse events (AEs) incidence in comparison with other 
      antibiotics (OR=1.06, 95% CI 0.71 to 1.59, p=0.76, I(2)=41%). The trend showed 
      that daptomycin might cause less discontinuation due to AEs and death compared 
      with other first-line antibiotics (OR=0.71, 95% CI 0.46 to 1.10, p=0.12, 
      I(2)=11%). Significantly more patients in the daptomyicn group had creatine 
      phosphokinase elevation than those in the control group; however, it could be 
      reversed when the therapy ended (OR=1.95, 95% CI 1.04 to 3.65, p=0.04, I(2)=0). 
      CONCLUSIONS: This meta-analysis demonstrated that the safety and efficacy of 
      daptomycin was not inferior to that of other first-line drugs, and daptomycin 
      tended to exhibit superior efficacy when compared with vancomycin or with 
      comparators for SA infections; nevertheless, more high-quality RCTs are needed to 
      draw a more credible conclusion.
CI  - Published by the BMJ Publishing Group Limited. For permission to use (where not 
      already granted under a licence) please go to 
      http://group.bmj.com/group/rights-licensing/permissions.
FAU - Wang, Shou Zhen
AU  - Wang SZ
AD  - Surgical Intensive Care Unit, First Affiliated Hospital of Guangxi Medical 
      University, Nanning, Guangxi, China.
FAU - Hu, Jun Tao
AU  - Hu JT
AD  - Surgical Intensive Care Unit, First Affiliated Hospital of Guangxi Medical 
      University, Nanning, Guangxi, China.
FAU - Zhang, Chi
AU  - Zhang C
AD  - Surgical Intensive Care Unit, First Affiliated Hospital of Guangxi Medical 
      University, Nanning, Guangxi, China.
FAU - Zhou, Wei
AU  - Zhou W
AD  - Surgical Intensive Care Unit, First Affiliated Hospital of Guangxi Medical 
      University, Nanning, Guangxi, China.
FAU - Chen, Xian Feng
AU  - Chen XF
AD  - Surgical Intensive Care Unit, First Affiliated Hospital of Guangxi Medical 
      University, Nanning, Guangxi, China.
FAU - Jiang, Liang Yan
AU  - Jiang LY
AD  - Surgical Intensive Care Unit, First Affiliated Hospital of Guangxi Medical 
      University, Nanning, Guangxi, China.
FAU - Tang, Zhan Hong
AU  - Tang ZH
AD  - Surgical Intensive Care Unit, First Affiliated Hospital of Guangxi Medical 
      University, Nanning, Guangxi, China.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Meta-Analysis
PT  - Review
DEP - 20140624
PL  - England
TA  - BMJ Open
JT  - BMJ open
JID - 101552874
RN  - 0 (Anti-Bacterial Agents)
RN  - NWQ5N31VKK (Daptomycin)
SB  - IM
MH  - Anti-Bacterial Agents/adverse effects/*therapeutic use
MH  - Bacterial Infections/*drug therapy
MH  - Daptomycin/adverse effects/*therapeutic use
MH  - Humans
MH  - Randomized Controlled Trials as Topic
MH  - Skin Diseases, Bacterial/*drug therapy
MH  - Soft Tissue Infections/*drug therapy
MH  - Treatment Outcome
PMC - PMC4078778
OTO - NOTNLM
OT  - Epidemiology
EDAT- 2014/06/26 06:00
MHDA- 2014/06/26 06:01
PMCR- 2014/06/24
CRDT- 2014/06/26 06:00
PHST- 2014/06/26 06:00 [entrez]
PHST- 2014/06/26 06:00 [pubmed]
PHST- 2014/06/26 06:01 [medline]
PHST- 2014/06/24 00:00 [pmc-release]
AID - bmjopen-2013-004744 [pii]
AID - 10.1136/bmjopen-2013-004744 [doi]
PST - epublish
SO  - BMJ Open. 2014 Jun 24;4(6):e004744. doi: 10.1136/bmjopen-2013-004744.